Weighting of risk factors for low birth weight: A linked routine data cohort study in Wales, UK

Weighting of risk factors for low birth weight: A linked routine data cohort study in Wales, UK
复制标题

低出生体重风险因素的加权：英国威尔士的一项关联常规数据队列研究

DOI：
10.1101/2022.03.23.22272809
复制
发表时间：
2022
期刊：
--
影响因子：
--
通讯作者：
Bandyopadhyay A
Bandyopadhyay A
中科院分区：
--
文献类型：
--
作者：
Bandyopadhyay A

文献摘要

相似文献

目的全球每年有2000万新生儿出生体重低于2500克，被认为是低出生体重儿（LBW）。本研究调查了具有全国代表性的威尔士儿童及其母亲e队列中可改变的风险因素的贡献，以告知减少LBW患病率的机会。设计一项基于匿名关联、常规收集的多个管理数据集的纵向队列研究。该队列（N=693 377）包括1998年1月1日至2018年12月31日在威尔士出生的儿童，从国家社区儿童健康数据库中选择。结果测量采用多变量logistic回归（MLR）和决策树（DT）模型研究与二元LBW（结果）变量相关的危险因素。结果MLR模型显示，非独生子女发生LBW的风险最高（调整OR为21.74 (95% CI为21.09 ~ 22.40)），其次是妊娠间隔小于1年（2.92 (95% CI为2.70 ~ 3.15)），母亲身心健康状况包括糖尿病（2.03(1.81 ~ 2.28)）、贫血（1.26 (95% CI为1.16 ~ 1.36)）、抑郁症（1.58 (95% CI为1.43 ~ 1.75)）、严重精神疾病（1.46 (95% CI为1.04 ~ 2.05)）。焦虑（1.22 (95% CI 1.08 - 1.38)）和妊娠期间使用抗抑郁药物（1.92 (95% CI 1.20 - 3.07)）。其他孕产妇危险因素包括吸烟（1.80 (95% CI 1.76至1.84)）、与酒精相关的住院（1.60 (95% CI 1.30至1.97)）、药物滥用（1.35 (95% CI 1.29至1.41)）和家庭暴力（1.98 (95% CI 1.39至2.81)）。生活在贫困程度较低的地区患LBW的风险较低（0.70 (95% CI 0.67 ~ 0.72)）。DT模型中最重要的危险因素包括母亲因素，如吸烟、母亲体重、药物滥用记录、母亲年龄以及剥夺-威尔士多重剥夺指数评分、怀孕间隔和孩子的出生顺序。结论降低低胎率的资源应集中在改善孕产妇健康，减少早产，提高对充足妊娠间隔的认识，并为母亲的心理健康和福祉提供足够的支持。
ObjectiveGlobally, 20 million children are born with a birth weight below 2500 g every year, which is considered as a low birthweight (LBW) baby. This study investigates the contribution of modifiable risk factors in a nationally representative Welsh e-cohort of children and their mothers to inform opportunities to reduce LBW prevalence.DesignA longitudinal cohort study based on anonymously linked, routinely collected multiple administrative data sets.ParticipantsThe cohort, (N=693 377) comprising of children born between 1 January 1998 and 31 December 2018 in Wales, was selected from the National Community Child Health Database.Outcome measuresThe risk factors associated with a binary LBW (outcome) variable were investigated with multivariable logistic regression (MLR) and decision tree (DT) models.ResultsThe MLR model showed that non-singleton children had the highest risk of LBW (adjusted OR 21.74 (95% CI 21.09 to 22.40)), followed by pregnancy interval less than 1 year (2.92 (95% CI 2.70 to 3.15)), maternal physical and mental health conditions including diabetes (2.03 (1.81 to 2.28)), anaemia (1.26 (95% CI 1.16 to 1.36)), depression (1.58 (95% CI 1.43 to 1.75)), serious mental illness (1.46 (95% CI 1.04 to 2.05)), anxiety (1.22 (95% CI 1.08 to 1.38)) and use of antidepressant medication during pregnancy (1.92 (95% CI 1.20 to 3.07)). Additional maternal risk factors include smoking (1.80 (95% CI 1.76 to 1.84)), alcohol-related hospital admission (1.60 (95% CI 1.30 to 1.97)), substance misuse (1.35 (95% CI 1.29 to 1.41)) and evidence of domestic abuse (1.98 (95% CI 1.39 to 2.81)). Living in less deprived area has lower risk of LBW (0.70 (95% CI 0.67 to 0.72)). The most important risk factors from the DT models include maternal factors such as smoking, maternal weight, substance misuse record, maternal age along with deprivation—Welsh Index of Multiple Deprivation score, pregnancy interval and birth order of the child.ConclusionResources to reduce the prevalence of LBW should focus on improving maternal health, reducing preterm births, increasing awareness of what is a sufficient pregnancy interval, and to provide adequate support for mothers’ mental health and well-being.